How omega-3 fatty acids might help Crohn's disease

2014-01-17 13:15
Omega-3 fatty acids: How they might help Crohn's disease

Finding ways to manage Crohn's disease is difficult. Interventions that work for some fail for others. Crohn's disease that is a form of inflammatory bowel disease or IBD is brought about by inflammation. Omega 3 fatty acids are shown to quell inflammation, so why aren't they being widely recommended for the disease?

Why omega-3 fatty acids could help Crohn's disease

We asked biochemist Dr. Barry Sears of the Zone diet what role omega-3 fatty acids might play for helping treat Crohn's disease. In an e-mail interview and what are other ways to help reduce inflammation that could also help lower the side effect of some treatment for Crohn’s disease.

In a review of studies, omega-3 fatty acids failed to show consistent benefit for treating IBD. Because of same, there are no firm recommendations. One of the reasons, says Dr. Sears is that the dosing used in studies was too low.

Drugs used to treat Crohn’s disease address the problem after inflammation happens. According to Dr. Sears, “Anti-inflammatory treatments (drugs or biologicals) deal with stopping inflammation after its initiation. The initiation phase of inflammation is caused by the activation of NF-kB which is the gene transcription factor that turns on the synthesis of inflammatory mediators (such as TNF). A more appropriate course of action would be to go "upstream" to reduce activation of NF-kB thus reducing the levels of inflammatory proteins being released.”

What that can mean for anyone dealing with Crohn’s disease is that eating anti-inflammatory foods is especially important. A diet rich in omega-3 fatty acids could have an impact over time that might reduce the amount of medications needed to control the disease.

“This also means reducing the intake of omega-6 fatty acids as well as increasing the omega-3 fatty acids. In my opinion, the levels of omega-3 fatty acids used in previous clinical studies are too low to effectively reduce NF-kB activity,” Dr. Sears explains.

Measuring inflammation

What that could mean for anyone dealing with a chronic inflammatory disease, that underlies most all diseases is that keeping one’s AA/EPA ratio low could be beneficial for Crohn’s management, overall health and other diseases.

Measuring the AA/EPA ratio the ratio of Arachidonic Acid (AA) to Eicosapentaenoic Acid (EPA) in the blood stream is easily done with a blood test. If the ratio is over 3, NF-kB activity is higher, Dr. Sears explains, based on suggestions from clinical studies.

Inflammation is implicated for promoting breast cancer, diabetes, depression and more.

How can you lower inflammation?

You can take omega-3 fatty acids (with your doctor’s approval). Dr. Sears says the dosing should be 5 to 10 grams a day.

"Polyphenols can also be used as anti-inflammatory agents. One by reducing the levels of pathogenic microbes in the gut as well as acting as secondary inhibitions of NF-kB activity. Like omega-3 fatty acids, polyphenols must also be used in therapeutic levels usually at the level of at least 1-2 grams of purified polyphenol extracts per day," Dr. Sears said.

He adds: “In summary, by following an anti-inflammatory diet like the Zone Diet coupled with high levels of omega-3 fatty acids and polyphenols can work at the molecular level to enhance the actions of currently used drugs suggesting that the levels of drugs can be significantly reduced since the molecular targets of both are the same." Other examples of anti-inflammatory diets include the Mediterranean diet and the anti-inflammatory diet recommended by Dr. Andrew Weil.

In an update interview, Dr. Sears shared the risk of bleeding from high dose fish oil or other omega-3 fatty acid supplements is low. We asked because patients are often recommended by clinicians to stop taking fish oil prior to surgery and other procedures or when new medications that thin the blood are added.

"It was demonstrated more than 20 years ago that high dose fish (16 grams per day) had no effect on bleeding times. It was also demonstrated in 1994 that native Alaskans who had a AA/EPA ratio that was between 0.9 and 1.5 had no difference in bleeding times compared to control subjects who had 14 times higher AA/EPA ratios. In 1995, it was shown that patients who received cardiovascular stents and anti-coagulants and 4 grams of fish oil per day didn't have any differences in bleeding times compared to those they did not get fish oil. A more recent study in 2009 confirmed that observation at 4 grams of fish oil per day had no effect on bleeding times in cardiovascular patients. In a large study published in 2012 there was no difference in bleeding times in cardiovascular patients depending on the omega-3 fatty acid levels in their blood. In six-month study using 7 grams of omega-3 fatty acids per day, there was no significant changes in the platelet aggregation time. Since the JELIS study of 18,000 Japanese indicated that the average AA/EPA is 1.6, all the current data would suggest that maintaining that AA/EPA ratio above 1.5 with high dose fish will have no effect on bleeding times."

Other ways to lower inflammation to treat chronic disease is to reduce stress and exercise regularly. Yoga and meditation are also recommended interventions that can calm harmful cytokines and inflammatory reactions in the body.

The essence of the anti-inflammatory Zone diet is "Eat as much protein as the palm of your hand, as much non-starchy raw vegetables as you can stand for the vitamins, enough carbohydrates to maintain mental clarity because the brain runs on glucose, and enough monounsaturated oils to keep feelings of hunger away."

You can download Dr. Sear’s audio book: “The Anti-Inflammation Zone: Reversing the Silent Epidemic That's Destroying Our Health” for more about the diet that is not weight loss approach.

If you are battling Crohn’s disease or IBD, omega-3 fatty acids, eating an anti-inflammatory diet and focusing the diet on polyphenols that are antioxidant and occur synthetically and in foods, could help manage inflammation of the colon. Speak with your doctor for an individualized treatment plan before changing your diet or adding any supplements. Quality studies are still needed to prove omega-3 fatty acids can help manage Crohn's disease and ulcerative colitis.

Resources:
"Polyunsaturated fatty acids and inflammatory bowel disease"
Am J Clin Nutr. 2000 Jan;71(1 Suppl):339
Belluzzi A, et al.

"N-3 polyunsaturated fatty acid diet therapy for patients with inflammatory bowel disease"
Inflamm Bowel Dis. 2010 Oct;16(10):1696-707. doi: 10.1002/ibd.21251.
Uchiyama K, et al.

"Dietary conjugated linoleic acid and n-3 polyunsaturated fatty acids in inflammatory bowel disease"
Curr Opin Clin Nutr Metab Care. 2010 Sep;13(5):569-73. doi: 10.1097/MCO.0b013e32833b648e.
Bassaganya-Riera J, Hontecillas R.

Updated 1/22/2014

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Comments

the effect of such diets is minimal to say the least.Feel strongly that such stories give false hope to sufferers of this horrible disease and comes from those with no real knowledge of such a potent condition.To suggest a 'med' diet cobined with a bit of yoga can combat crohns is bullshit at best
It's a part of a total lifestyle approach that in no way excludes medications or conventional therapies. Everyone responds differently to different interventions. Some people do use meditation, yoga, relaxation and breathing to manage Crohn's disease and they are pleased with the results. Inflammatory foods could in no way help. It only makes sense. Some people eat lard saying it soothes their symptoms, which I do not understand at all. This is one approach that could be tried in addition to whatever other treatment is being used.